MYMICHIGAN MEDICAL CENTER CLARE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MYMICHIGAN MEDICAL CENTER CLARE (EIN 38-1518643)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201231369349306913
Schema version
2010v3.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-15T15:47:28-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDREWS HOOPER PAVLIK PLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15300 GRATIOT RDAddressLine1
CitySAGINAWCity
StateMIState
ZIP Code486386035ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN381518643EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN MEDICAL CENTER - CLAREBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMIDMNameControl
Phone9898393181Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1703 NORTH MCEWAN STREETAddressLine1
CityCLARECity
StateMIState
ZIP Code48617ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANCINE M PADGETTName
TitleSR. VP & TREASURERTitle
Phone9898393181Phone
Date Signed2012-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLAURA M EBELName
Phone9894975300Phone
Date Prepared2012-05-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLAWRENCE BARCONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1703 NORTH MCEWAN STREETAddressLine1
CityCLARECity
StateMIState
ZIP Code48617ZIPCode
FieldValueIRS element (for citing)
Gross Receipts54516927GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MIDMICHIGAN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1951YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees400TotalNbrEmployees
Total Nbr Volunteers111TotalNbrVolunteers
Total Gross UBI18928TotalGrossUBI
Net Unrelated Business Txbl Income706NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year66093ContributionsGrantsPriorYear
Contributions Grants Current Year33962ContributionsGrantsCurrentYear
Program Service Revenue Prior Year42767444ProgramServiceRevenuePriorYear
Program Service Revenue CY44482419ProgramServiceRevenueCY
Investment Income Prior Year985830InvestmentIncomePriorYear
Investment Income Current Year1589922InvestmentIncomeCurrentYear
Other Revenue Prior Year528625OtherRevenuePriorYear
Other Revenue Current Year573177OtherRevenueCurrentYear
Total Revenue Prior Year44347992TotalRevenuePriorYear
Total Revenue Current Year46679480TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year17627924SalariesEtcPriorYear
Salaries Etc Current Year18646194SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year25249919OtherExpensePriorYear
Other Expenses Current Year28259855OtherExpensesCurrentYear
Total Expenses Prior Year42877843TotalExpensesPriorYear
Total Expenses Current Year46906049TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1470149RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-226569RevenuesLessExpensesCY
Total Assets BOY42225655TotalAssetsBOY
Total Assets EOY43087648TotalAssetsEOY
Total Liabilities BOY18216278TotalLiabilitiesBOY
Total Liabilities EOY16969081TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY24009377NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY26118567NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense40046106Expense
Revenue44482419Revenue
DescriptionMIDMICHIGAN MEDICAL CENTER - CLARE PROVIDES COMPASSIONATE PATIENT CARE SERVICES OF SUPERIOR QUALITY TO CLARE AND ITS SURROUNDING COUNTIES. 1,608 PATIENT ADMISSIONS AND 92,744 OUTPATIENT VISITS WERE RECORDED IN FISCAL YEAR 2011. CARE IS PROVIDED WITHOUT RESPECT TO PATIENTS ABILITY TO PAY.Description
Total Program Service Expense40046106TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109631NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees400NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonFM PADGETT SR VP TREASURERNamePerson
Telephone Number9898393181TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14000 WELLNESS DRAddressLine1
CityMIDLANDCity
StateMIState
ZIP Code48670ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
RICHARD REYNOLDS
DIRECTOR50.00X0683552282389
TOM CLARINGBOLD DO
DIRECTOR50.00X029139240786
LAWRENCE BARCO
PRESIDENT50.00X286921031635X
DAVID BREMER MD
DIRECTOR50.00X022125248038
ROBERT VANDERBROOK MD
DIRECTOR50.00X021870914677
RAJANI MALLICK MD
DIRECTOR50.00X015021713751
CARRIE NICHOLSON MD
SECRETARY50.00X012194319042
MICHAEL BEADLE
DIRECTOR2.00X000
MIKE JENKINS
DIRECTOR2.00X000
JEFF PUNCHES
DIRECTOR2.00X000
DAVID REECE
DIRECTOR2.00X000
DON RICHARDS
DIRECTOR2.00X000
CARL SCHWIND
CHAIR2.00X000
DAN TIMMINS
TREASURER2.00X000
RON VERCH
VICE CHAIR2.00X000
LISA BENIC
DIRECTOR2.00X000
AMY STARK
DIRECTOR2.00X000
VICTOR MORGAN
CONTROLLER50.00014177623723X
JOSHUA WIGGINS
CONTROLLER50.0008524623009X
EDWARDO MUNOZ
CRNA50.0024696502330X
WILLIAM GROVES
CRNA50.00209745025554X
DUSTIN FORNEY
CRNA50.00207057024675X
RUSSELL RADER
ANESTHESIOLO50.00190389021430X
GLENN KING
VP50.00151030023852X
RAYMOND STOVER
FORMER CONTR50.00019207450777X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1292107TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2106161TotalReportableCompFrmRltdOrgs
Total Other Compensation645668TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HOSPITALIST PHYS MED GROUP OF MI
2000 GREEN RD SUITE 300ANN ARBORMI48105PHYSICIAN SVCS943857
MAYO COLLABORATIVE SERVICE INC
201 1ST ST SWROCHESTERMN55905REFERENCE LAB234318
SOURCECORP HEALTHSERVE RAD INC
PO BOX 142589 DRAWER 9039IRVINGTX750142589TELERADIOLOGY111584
EMERG PHYSICIANS MEDICAL
2000 GREEN RD SUITE 300ANN ARBORMI48105ER ADMIN105278
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
All Other Contributions33962AllOtherContributions
Total Contributions33962TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MEDICARE/MEDICAID PAYMENTS6219902628466426284664
NET PATIENT REVENUE6219901797604317976043
CONTRACTED CLINICAL SERVICES621990202784202784
REFERENCE LABORATORY6215001892818928
FieldValueIRS element (for citing)
Total Program Service Revenue44482419TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column308815TotalRevenueColumn
Exclusion$308,815ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column21TotalRevenueColumn
Exclusion$21ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities9118533Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7765911Securities
Other71536Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1352622Securities
Other-71536Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1281086TotalRevenueColumn
Exclusion$1,281,086ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
AFFILIATE RELATED INCOME900099389826389826
CAFETERIA/FOOD SERVICE72221093803$93,803
OUTSIDE INCOME9000995394853948

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column35600TotalRevenueColumn
Related Or Exempt Function Income35600RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue573177TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column46679480TotalRevenueColumn
Related Or Exempt Function Income44942865RelatedOrExemptFunctionIncome
Unrelated Business Revenue18928UnrelatedBusinessRevenue
Exclusion$1,683,725ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total319182Total
Program Services159591ProgramServices
Management And General159591ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total14791315Total
Program Services13555974ProgramServices
Management And General1235341ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total571031Total
Program Services512089ProgramServices
Management And General58942ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1916755Total
Program Services1813120ProgramServices
Management And General103635ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1047911Total
Program Services958051ProgramServices
Management And General89860ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total7988Total
Management And General7988ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total26100Total
Management And General26100ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total41114Total
Management And General41114ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6405212Total
Program Services4113350ProgramServices
Management And General2291862ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total16305Total
Program Services1837ProgramServices
Management And General14468ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4825745Total
Program Services4541226ProgramServices
Management And General284519ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total761927Total
Program Services12564ProgramServices
Management And General749363ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total41811Total
Program Services37931ProgramServices
Management And General3880ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1592800Total
Program Services1130717ProgramServices
Management And General462083ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total60013Total
Program Services52273ProgramServices
Management And General7740ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total48200Total
Program Services46900ProgramServices
Management And General1300ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total560728Total
Management And General560728ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1929430Total
Program Services1197743ProgramServices
Management And General731687ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total29742Total
Management And General29742ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PHYSICIAN SUBSIDY63221266322126
UNCOMPENSATED SERVICES43769334376933
QAAP FEES12136811213681

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total46906049Total
Program Services40046106ProgramServices
Management And General6859943ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1495BOY
EOY1545EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY314414BOY
EOY479757EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3655245BOY
EOY4345998EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY10669BOY
EOY8745EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY492492BOY
EOY398747EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis31072376LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec17082032LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14412818BOY
EOY13990344EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4825228BOY
EOY3503665EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY18308681BOY
EOY20166516EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY204613BOY
EOY192331EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY42225655BOY
EOY43087648EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4309133BOY
EOY4576408EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY10825143BOY
EOY10880784EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY550000BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2532002BOY
EOY1511889EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18216278BOY
EOY16969081EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY24003712BOY
EOY26112382EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5665BOY
EOY6185EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24009377BOY
EOY26118567EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY42225655BOY
EOY43087648EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-226569ReconcilationRevenueExpenses
Reconcilation Other Changes2335759ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1826668OtherCostOrOtherBasis
Book Value1826668BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis14315311OtherCostOrOtherBasis
Depreciation7355590Depreciation
Book Value6959721BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis830706OtherCostOrOtherBasis
Depreciation503158Depreciation
Book Value327548BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis13813519OtherCostOrOtherBasis
Depreciation9223284Depreciation
Book Value4590235BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis286172OtherCostOrOtherBasis
Book Value286172BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13990344TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionOTHER FINANCIAL INVESTMENTSDescription
Book Value20166516BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities20166516TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
SELF INSURANCE, OTHER$1,254,880
INTERCOMPANY LOANS$257,009
FieldValueIRS element (for citing)
Total Of Amounts1511889TotalOfAmounts
Total Revenue46679480TotalRevenue
Total Expenses46906049TotalExpenses
Excess Or Deficit For Year-226569ExcessOrDeficitForYear
Net Unrealized GL On Investments2335759NetUnrealizedGLOnInvestments
Total Adjustments2335759TotalAdjustments
Excess Or Deficit Per FS2109190ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt49062426TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments2335759NetUnrealizedGainsInvestments
Other Revenues16765OtherRevenues
Revenue Not Rptd F9902352524RevenueNotRptdF990
Revenue Subtotal46709902RevenueSubtotal
Investment Expenses Not Included41114InvestmentExpensesNotIncluded
Other Revenues Not Included-71536OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-30422RevenueNotRptdOnFinStmt
Total Revenue Per Form99046679480TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt46967462TotExpensesEtcAuditedFinclStmt
Other Expenses Included30991OtherExpensesIncluded
Expenses Not Rptd F99030991ExpensesNotRptdF990
Expenses Subtotal46936471ExpensesSubtotal
Investment Expenses Not Included241114InvestmentExpensesNotIncluded2
Other Expenses Not Included-71536OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-30422ExpensesNotRptdOnFinStmt
Total Expenses Per Form99046906049TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8NET ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL -14,226 NET ASSETS RELEASED FROM RESTRICTIONS 30,991 LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED 71,536 NET ASSETS RELEASED FROM RESTRICTIONS -30,991 LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -71,536
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DNET ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL -14,226 NET ASSETS RELEASED FROM RESTRICTIONS 30,991
REVENUE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 4BLOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -71,536
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 2DNET ASSETS RELEASED FROM RESTRICTIONS 30,991
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 4BLOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -71,536

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense420388TotalCommunityBenefitExpense
Net Community Benefit Expense420388NetCommunityBenefitExpense
Percent Of Total Expense0.00900PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense8235510TotalCommunityBenefitExpense
Direct Offsetting Revenue5735934DirectOffsettingRevenue
Net Community Benefit Expense2499576NetCommunityBenefitExpense
Percent Of Total Expense0.05330PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense8655898TotalCommunityBenefitExpense
Direct Offsetting Revenue5735934DirectOffsettingRevenue
Net Community Benefit Expense2919964NetCommunityBenefitExpense
Percent Of Total Expense0.06230PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense144045TotalCommunityBenefitExpense
Direct Offsetting Revenue13705DirectOffsettingRevenue
Net Community Benefit Expense130340NetCommunityBenefitExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense40814TotalCommunityBenefitExpense
Net Community Benefit Expense40814NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense16189TotalCommunityBenefitExpense
Net Community Benefit Expense16189NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense201048TotalCommunityBenefitExpense
Direct Offsetting Revenue13705DirectOffsettingRevenue
Net Community Benefit Expense187343NetCommunityBenefitExpense
Percent Of Total Expense0.00400PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense8856946TotalCommunityBenefitExpense
Direct Offsetting Revenue5749639DirectOffsettingRevenue
Net Community Benefit Expense3107307NetCommunityBenefitExpense
Percent Of Total Expense0.06620PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense2480TotalCommunityBuildingExpense
Net Community Building Expense2480NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense326TotalCommunityBuildingExpense
Net Community Building Expense326NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense23142TotalCommunityBuildingExpense
Net Community Building Expense23142NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense9918TotalCommunityBuildingExpense
Net Community Building Expense9918NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense51698TotalCommunityBuildingExpense
Net Community Building Expense51698NetCommunityBuildingExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense87564TotalCommunityBuildingExpense
Net Community Building Expense87564NetCommunityBuildingExpense
Percent Of Total Expense0.00190PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,838,675BadDebtExpenseAmount
Amount Attributable To181079AmountAttributableTo
Amount Reimbursed By Medicare12901320AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare14764522CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1863202MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN MEDICAL CENTER - CLAREBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1703 N MCEWAN STAddressLine1
CityCLARECity
StateMIState
ZIP Code486171440ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN MEDICAL CENTER - CLAREBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
MIDMI MEDICAL CENTER-CLARE REHAB SV
231 SOURTH FIRST STREETHARRISONMI48625REHABILITATION SERVICES ONLY
MIDMICHIGAN HEALTH PARK-HOUGHTON LK
9249 W LAKE CITY ROADHOUGHTON LAKEMI48629REHABILITATION, LAB, & MAMMOGRAPHY
MIDMICHIGAN URGENT CARE - CLARE
700 WEST FIFTH STCLAREMI48617URGENT CARE, OCCUPATIONAL MEDICINE
CLARE MMO RHC
602 BEECH STREETCLAREMI48617RURAL HEALTH CLINIC
HARRISON RHC
815 NORTH CLARE AVENUEHARRISONMI48625RURAL HEALTH CLINIC
FARWELL RHC
2812 WEST CADILLAC DRIVEFARWELLMI48622RURAL HEALTH CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COMMUNITY BUILDING ACTIVITIESPART IIMIDMICHIGAN MEDICAL CENTERCLARE STAFF CONTRIBUTED MANY HOURS AS MEMBERS OF COMMUNITY BOARDS CIVIC ORGANIZATIONS ADVISORY COMMITTEES COALITIONS AND WORK GROUPS THERE ARE MEMBERS OF THE CHAMBER OF COMMERCE IN ALL AFFILIATES WHICH ASSISTS THE COMMUNITY WITH SMALL BUSINESS DEVELOPMENT AND PROVIDES FINANCIAL SUPPORT FOR YOUTH LEADERSHIP PROGRAMS MIDMICHIGAN MEDICAL CENTERCLARE ALSO SPENT OVER 47000 IN PHYSICIAN RECRUITMENT FOR THE FISCAL YEAR OF 2011 STAFF MEMBERS SERVE ON HEALTH AND HUMAN SERVICE BOARDS AND OR COMMITTEES FOR ALL COUNTIES PROVIDING OVERSIGHT OF COMMUNITY GRANT REQUESTS FOR HUMAN SERVICES PROJECTS PARTICIPATING IN STRATEGIC INITIATIVES SUCH AS THE YOUTH MASTER PLAN IN MIDLAND AND THE CHILDHOOD OBESITY PREVENTION INITIATIVE IN ALMA AND PARTICIPATING IN STRATEGIC INITIATIVES SUCH AS THE HOMELESSNESS STUDY BEHAVIORAL RISK FACTOR SURVEY FROM WHICH NUMEROUS COMMUNITY OUTREACH ENDEAVORS ARE DIRECTED ACCESS TO CARE AND SUBSTANCE ABUSE PREVENTION STAFF ALSO PARTICIPATES IN COMMITTEES ENGAGED IN IMPROVING THE HEALTH OF THE COMMUNITY LIKE THE TOGETHER WE CAN ADVISORY COMMITTEE WHICH INVOLVES CLARE ISABELLA AND GLADWIN COUNTY PROVIDERS ALSO DONATE THEIR TIME TO ATTEND EVENTS OR YOUTH CAMPS WITH IN THE COUNTY SUCH AS CAMP NEYTI THE 4H CAMP PROVIDING HEALTH SERVICES TO CAMPERS
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4OTHER UNCOMPENSATED CARE REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH PAYMENT IS EXPECTED AT THE TIME SERVICE IS PROVIDED BUT PAYMENT IS NOT RECEIVED OR IS LESS THAN THE COST INCURRED TO PROVIDE THE SERVICE THE FOLLOWING IS INCLUDED AS PROGRAMS AND SERVICES RELATED TO OTHER UNCOMPENSATED CARE UNCOMPENSATED SERVICES AT COSTREPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH A FEE HAS BEEN ASSESSED BUT NOT COLLECTED OR ONLY A PORTION OF THE COST OF THE RENDERED SERVICE HAS BEEN RECOVERED LINE 2 COSTING METHODOLOGY AN AVERAGE COSTTOCHARGE RATIO IS APPLIED TO THE CHARGE WRITEOFF THE RATIO IS CALCULATED BY REMOVING FROM TOTAL EXPENSE THE OTHER OPERATING INCOME UNCOMPENSATED CARE EXPENSE AND THE DIRECTLY ASSIGNED MEDICAID ASSESSMENT EXPENSE THEN DIVIDING THIS NET EXPENSE BY TOTAL GROSS PATIENT REVENUES THIS RATIO IS MULTIPLIED WITH THE CHARITY CARE CHARGES AND UNCOMPENSATED CARE CHARGES WRITTEN OFF FOR THE RELATED EXPENSE LINE 3 HISTORICAL COLLECTION ACTIVITY IS USED TO ESTIMATE THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE
MEDICARE EXPLANATIONPART III LINE 8THE SOCIAL SECURITY ACT AMENDMENT TO ESTABLISH MEDICARE STATES THAT MEDICARE WILL NOT PAY THE COST TO PROVIDE CARE TO NONBENEFICIARIES AND NONBENEFICIARIES WILL NOT PAY THE COST OF CARE FOR BENEFICIARIES WHEN MEDICARE DOES NOT PAY RATES THAT COVER ALL THE COST OF CARE FOR BENEFICARIES IT BECOMES A COMMUNITY BURDEN THEREFORE THE FULL AMOUNT OF SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT THIS ORGANIZATION BELIEVES THE AUDITED FINANCIAL STATEMENT CALCULATION IS A MORE ACCURATE DETERMINATION OF COST THAN THE MEDICARE ALLOWABLE COSTS USED FOR COST REPORTS THAT ARE REQUIRED TO BE UTILIZED ON THIS SCHEDULE IN PART III SECTION B THE AUDITED FINANCIAL STATEMENTS INCLUDE ALL MEDICARE REVENUES AND COSTS AND ALSO USE A COSTTOCHARGE RATIO METHOD THE AUDIT CALCULATION REPORTS A MEDICARE SHORTFALL OF 3194084 FOR THIS ORGANIZATION FOR THE FISCAL YEAR ENDED JUNE 30 2011
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BMIDMICHIGAN HEALTH DOES NOT TRY TO COLLECT FROM THOSE WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE MIDMICHIGAN HEALTHS COLLECTION POLICY STATES THAT THE PURPOSE OF THE POLICY IS TO PROVIDE COST EFFECTIVE PAYMENT OPTIONS TO PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE PER FINANCIAL AIDCHARITY CARE POLICY AND EITHER HAVE NO INSURANCE OR HAVE A BALANCE AFTER INSURANCE WHICH IS THEIR RESPONSIBILITY TO PAY MIDMICHIGAN HEALTH ALSO OFFERS PATIENTS A CREDIT CARD PAYMENT PROGRAM ALLOWING PATIENTS TO PAY THEIR BALANCE AT 000 INTEREST OVER 1236 MONTHS DEPENDING ON THE PATIENT BALANCE
NEEDS ASSESSMENTPART VIMIDMICHIGAN MEDICAL CENTERCLARE WORKS CLOSELY WITH LOCAL GOVERNMENTAL AND SERVICE ORGANIZATIONS AS WELL AS THE PUBLIC HEALTH DEPARTMENT TO ASSESS THE NEEDS OF THE COMMUNITY SERVED DATA FROM A VARIETY OF LOCAL AND NATIONAL SOURCES IS UTILIZED TO DETERMINE CURRENT HEALTH CARE TRENDS AND HEALTH CARE ISSUES AND TO PRIORITIZE AND EVALUATE HEALTH CARE PROGRAM PROGRESS SOURCES FOR GENERAL HEALTH DATA FOLLOW CDC MICHIGAN BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM BRFSS 20062008 COMBINED ADULT AND YOUTH COUNTY HEALTH RANKINGS UNIVERSITY OF WISCONSIN DATA CDC DATA AND STATISTICS USED FOR GENERAL AND AGE SPECIFIC AND HEALTH CONDITION DATA SUCH AS AGING TOBACCO USE VACCINES AND IMMUNIZATIONS MICHIGAN DEPARTMENT OF COMMUNITY HEALTH MDCH VITAL STATISTICS DHHS COMMUNITY HEALTH STATUS INDICATORS DHHS MEDICARE COMPARE DHHS MATERNAL AND CHILD HEALTH RESOURCE CENTER US DEPARTMENT OF HEALTH AND HUMAN SERVICES STATISTICS LINKS ADDITIONALLY WE USE DISEASE SPECIFIC DATA FROM NATIONAL ORGANIZATIONS LIKE THE AMERICAN CANCER SOCIETY THE AMERICAN DIABETES ASSOCIATION WHO COUNTRY AND REGIONAL DIABETES DATA AMERICAN HEART ASSOCIATION HEART AND OBESITY PREVENTION INFORMATION NATIONAL CANCER INSTITUTE CANCER STUDIES AND CDC FUNDED STATISTICS ON HIVAIDS LUNG CANCER SEXUALLY TRANSMITTED DISEASES NATIONAL CENTER FOR HEALTH STATISTICSMENTAL DISORDERS FOR HEALTH CARE COVERAGE AND FINANCE WE REFER TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES RESEARCH STATISTICS AND DATA SYSTEMS NATIONAL CENTER FOR HEALTH STATISTICS THE US CENSUS BUREAU AND THE KAISER FAMILY FOUNDATION WE COLLABORATE WITH LOCAL AGENCIES TO HELP DETERMINE AND RESPOND TO LOCAL NEEDS FOR EXAMPLE THE MIDMICHIGAN COMMUNITY ACTION AGENCY COMMUNITY NEEDS ASSESSMENT IS COMPLETED EVERY THREE YEARS AND INCLUDES CLARE GLADWIN AND MIDLAND COUNTIES THIS SURVEY ADDRESSES HEALTH CARE COST INCLUDING PRESCRIPTION MEDICATIONS AFFORDABLE PREVENTATIVE HEALTH CARE AND TRANSPORTATION TO SERVICES WE ALSO SIT ON A COLLABORATIVE PARTNERSHIP HEADED BY THE HEALTH DEPARTMENT CALLED TOGETHER WE CAN AND A SMALLER SUBSET OF THAT GROUP THE CLAREGLADWIN HEALTH IMPROVEMENT PLAN IN WHICH ADDRESSES WAYS COMMUNITY ORGANIZATIONS CAN IMPLEMENT PROGRAMS TO BETTER OVERALL COUNTY HEALTH AND THEIR RANKINGS AS DETERMINED BY THE ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS ONE EXAMPLE OF HOW STATISTICAL INFORMATION IS USED BASED UPON HIGHER THAN AVERAGE STROKE RATES WE PROVIDE LOWCOST STROKE SCREENINGS TARGETED AT THOSE WHO ARE AT HIGHEST RISK FOR DEVELOPING A STROKE AND PEOPLE WHO ARE LESS LIKELY TO BE GETTING REGULAR CARE FROM A DOCTOR ANOTHER DETERMINATION OF PROGRAM OFFERINGS IS PROGRAM EVALUATIONS THAT ARE GIVEN OUT AFTER EVERY OUTREACH EVENT THESE EVALUATIONS ASK A VARIETY OF QUESTIONS TO RATE THE PROGRAM AS WELL AS SUGGEST OTHER COMMUNITY PROGRAM OFFERINGS
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIMIDMICHIGAN MEDICAL CENTERCLARE COMMUNICATES TO PATIENTS AND THE PUBLIC OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE THROUGH INFORMATIONAL BROCHURES AT REGISTRATION AREAS AND THROUGH PATIENT ACCOUNTING COUNSELORS PATIENT ACCOUNTING COUNSELORS ARE TRAINED TO HELP PATIENTS OBTAIN FREE OR LOWCOST HEALTH INSURANCE OR TO WORK WITH PATIENTS TO PROVIDE CHARITY CARE OR FINANCIAL AID BASED ON THEIR FINANCIAL STATUS ADDITIONALLY SOCIAL WORKERS PROVIDE INFORMATION BOTH WRITTEN AND VERBAL ABOUT PROGRAMS FOR ASSISTANCE THEY ALSO COORDINATE WITH THE MEDICAID ELIGIBILITY REPRESENTATIVE FROM DHS FOR FOLLOWUP OR EXPEDITED APPLICATIONS THEY PROVIDE MEDICAID APPLICATIONS PERSONAL FINANCIAL STATEMENTS FOR HOSPITAL CHARITY CARE AND REFER TO THE PATIENT ACCOUNTING COUNSELORS
COMMUNITY INFORMATIONPART VIMIDMICHIGAN MEDICAL CENTERCLARES PRIMARY SERVICE AREA IS COMPRISED OF 4 ZIP CODES WHICH CAPTURES ALL OF CLARE COUNTY 847 OF THEIR DISCHARGES ORIGINATED IN CLARE COUNTY AND THEIR INPATIENT MARKET SHARE IS 306 MIDMICHIGAN MEDICAL CENTERMIDLAND ALSO SERVES THIS COMMUNITY RECEIVING A 235 MARKET SHARE FOLLOWED BY MCLAREN CENTRAL MICHIGAN WITH A 140 MARKET CAPTURE CLARE COUNTY IS A DESIGNATED MEDICALLY UNDERSERVED POPULATION AS WELL AS A DESIGNATED GEOGRAPHIC SINGLE COUNTY HEALTHCARE PROVIDER SHORTAGE AREA DEMOGRAPHICS 2011 OVER AVERAGE NUMBER OF MEDIAN POPULATION 65 YEARS INCOME HOUSEHOLDS AGE 32150 191 44174 13307 445 RACE PERCENT WHITE PERCENT PERCENT PERCENT PERCENT CAUCASIAN ASIAN INDIAN HISPANIC BLACK 964 03 09 17 07
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VIOUR FOCUS ON IMPROVING THE HEALTH OF OUR COMMUNITIES IS REFLECTED IN OUR MISSION VALUES AND VISION ADDITIONALLY THERE ARE ACTIVE COMMUNITY MEMBER BOARDS AT ALL AFFILIATES WHO OVERSEE COMMUNITY OUTREACH ENDEAVORS WE PARTNER ON NEEDED HEALTH INITIATIVES WORKING WITH LOCAL PUBLIC HEALTH DEPARTMENTS AND HHS TO UNDERSTAND THE UNIQUE HEALTH NEEDS OF EACH OF OUR COMMUNITIES MIDMICHIGAN MEDICAL CENTERCLARE ADMINISTRATORS SIT ON VARIOUS COMMUNITY BOARDS OF DIRECTORS BOD SUCH AS THE MID MICHIGAN COMMUNITY COLLEGE NURSING BOD SAGINAW VALLEY STATE UNIVERSITY NURSING ADVISORY BOD CLARE INDUSTRIAL DEVELOPMENT CORPORATION BOD MIDDLE MICHIGAN DEVELOPMENT CORPORATION BOD MID MICHIGAN COMMUNITY HEALTH SERVICES BOD AND THE CENTRAL HEALTH PLAN BOD
AFFILIATED HEALTH CARE INFORMATIONPART VI59 MILLION IN COMMUNITY BENEFITS WAS PROVIDED BY MIDMICHIGAN HEALTH LAST YEAR THROUGH COMMUNITY EDUCATION PROGRAMS SCREENINGS SPECIAL EVENTS AND HEALTH EXPERTISE INCLUDING INSURANCE UNDERREIMBURSEMENTS AND SERVICES TO THOSE WHO COULD NOT PAY AS HEALTH INDICATORS SHOW INCREASING OBESITY AND CHOLESTEROL LEVELS AND DECREASING PHYSICAL ACTIVITY AMONG CHILDREN HEALTH FAIRS REACHED OUT TO ENCOURAGE AND TEACH THEM ABOUT REGULAR EXERCISE GOOD NUTRITION AND MAINTAINING A HEALTHY WEIGHT MIDMICHIGAN HEALTH COLLABORATED WITH SCHOOLS ON SOME OF THESE PROGRAMS ONE OF THE MANY PROGRAMS OFFERED BY MIDMICHIGAN MEDICAL CENTERGLADWIN FITTED KIDS FOR NEW BIKE HELMETS 3107 CHILDREN AGES NEWBORN THROUGH MIDDLE SCHOOL LEARNED HEALTHY OPTIONS DURING HEALTH FAIRS THROUGHOUT THE REGION PROGRAMS FOCUSED ON PERIPHERAL VASCULAR DISEASE STROKE AND BLOOD PRESSURE HELPED PEOPLE IN OUR AREA IDENTIFY AND TREAT CONDITIONS RELATED TO HEART DISEASE THEY LEARNED HOW TO EAT BETTER EXERCISE MORE AND MODIFY LIFESTYLE CHOICES TO LOWER THEIR RISK 1300 PEOPLE PARTICIPATED IN ACTIVITIES RELATED TO HEART DISEASE PREVENTION AT A COST OF 66000 AT COMMUNITY RUNS AND OTHER ACTIVITIES WHICH OFTEN INCLUDE KIDS TRIATHLON OR RUNWALK EVENTS MIDMICHIGAN EXPERTS HELP PEOPLE REACH FOR A MORE ACTIVE LIFESTYLE AT ASSOCIATED HEALTH FAIRS FOR MIDLAND COMMUNITY CENTERS 2011 DOW RUNWALK MIDMICHIGAN HELD PRERACE CLASSES TO TEACH HEALTHY EXERCISE AND EMPLOYEES AND FAMILIES CONTINUED THE RUN OR WALK WITH YOUR DOC TRADITION MORE THAN 25 FITNESS OR EXERCISE RELATED EVENTS FROM MIDMICHIGAN REACHED MORE THAN 6000 PEOPLE LAST YEAR AT A COST TO MIDMICHIGAN OF 57000 THE 8TH ANNUAL FUN DAY IN THE PARK IN CLARE IS ONE OF DOZENS OF EVENTS WHERE PEOPLE GET TO KNOW THE COMMUNITY AND LEARN SAFETY ADVICE AND INFORMATION ABOUT DEVELOPING HEALTHY HABITS 3854 COMMUNITY OUTREACH EVENTS SUCH AS EDUCATIONAL PROGRAMS AND SCREENINGS WERE PROVIDED TO 101853 PEOPLE BY PHYSICIANS AND OTHER HEALTH CARE EXPERTS FROM MIDMICHIGAN HEALTH LAST YEAR A VARIETY OF CLINICALLY PROVEN WEIGHT LOSS AND WEIGHT MANAGEMENT APPROACHES ARE OFFERED BY MIDMICHIGAN HEALTH THESE INCLUDE THE WOW PROGRAM THE AM I HUNGRY PROGRAM AND HEALTH COACHING PROGRAMS AT MIDMICHIGAN MEDICAL CENTERS IN MIDLAND AND ALMA 2 SHAMROCK SHRINKDOWN INDIVIDUAL WEIGHTLOSS COMPETITIONS HELPED CLOSE TO 100 PEOPLE FROM THE CLARE AREA IMPROVE THEIR HEALTH THE THREEMONTH PROGRAMS WERE COMMUNITY COLLABORATIONS WITH THE CITY OF CLARE PARKS AND RECREATION DEPARTMENT
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILEDPART VIMICHIGAN
ADDITIONAL INFORMATIONPART VIPART I LINE 3A AND 3B AS WELL AS USING THE FEDERAL POVERTY GUIDELINES THE PATIENTS AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT ARE TAKEN INTO CONSIDERATION WHEN DETERMINING FREE OR DISCOUNTED CARE PATIENTS WHOSE FAMILY INCOME EXCEEDS 200 OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASEBYCASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredfalseSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
RICHARD REYNOLDS
4976761750001087625788724502965941
TOM CLARINGBOLD DO
237571529628592580314983332178
LAWRENCE BARCO
18742584000154961462517010318556
DAVID BREMER MD
1559506332319793542412614269290
ROBERT VANDERBROOK MD
155853623854711014667233386
RAJANI MALLICK MD
126480233803571013741163968
VICTOR MORGAN
1036572500013119173806343165499
EDWARDO MUNOZ
2032844000036811782548249295
WILLIAM GROVES
199266104791061514939235299
DUSTIN FORNEY
183845175005712864116034231732
RUSSELL RADER
1812059184968411746211819
GLENN KING
117603250008427799715855174882
RAYMOND STOVER
14139539400112793293917838242851

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NON-FIXED PAYMENTS PROVIDEDSCHEDULE J, PAGE 1, PART I, LINE 7MIDMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES (60% OF MEDIAN). THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS APPROVED COMPENSATION FOR THE MIDMICHIGAN HEALTH CEO, ALL OPERATING OFFICERS AND COMPENSATION FOR THE AFFILIATE CEOS, OPERATING OFFICERS AND PHYSICIANS. THE AFFILIATE BOARDS OF DIRECTORS REVIEWED ALL FIXED AND NONFIXED PAYMENTS FOR THEIR CEO AND OPERATING OFFICERS PRIOR TO PAYMENT.
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIION MAY 8, 2009 MIDMICHIGAN HEALTH'S COMPENSATION COMMITTEE APPROVED ITS FIRST COMPENSATION COMMITTEE CHARTER AND EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH APPROVED BOTH THE CHARTER AND THE STRATEGY ON JUNE 8, 2009. MIDMICHIGAN HEALTH ALSO UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES, HOSPITAL LEVEL AND EXECUTIVES AND SELECTED OTHER EXECUTIVES. MIDMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MIDMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE, PRIMARILY IN THE MIDWEST AND REGIONALLY, BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY. PART I, LINE 4B - REYNOLDS AND BARCO ARE PARTICIPANTS IN A 457(F) PLAN. THERE WERE NO PAYMENTS MADE IN 2010. THE SERP IS UNFUNDED AND BEGAN ON JANUARY 1, 2009. THE CURRENT PARTICIPANTS OF THE PLAN ARE THOSE WHO HOLD A CORPORATE OFFICE OF VICE PRESIDENT OR ABOVE. EACH PARTICIPANTS ANNUAL AWARD IS A BENEFIT RESTORATION AMOUNT THAT PROVIDES THE ADDITIONAL BENEFITS THAT THE PARTICIPANT DID NOT EARN UNDER THE PENSION PLAN AND 403(B) PLAN DURING A PLAN YEAR BECAUSE OF THE STATUTORY LIMITS. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MIDMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: ATTAINMENT OF NORMAL RETIREMENT AGE; DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; OR, PROVIDED THEY HAVE BEEN EMPLOYED AT LEAST FIVE YEARS AND THE PARTICIPANT EARNS 75 POINTS.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
2006A MI STATE HOSPITAL FINANCE
38288941759465HEB82006-11-074332800CAPITAL PROJECTSfalsefalsefalse
MICHIGAN FINANCE AUTHORITY SER D
8005961862011-06-09455850CAPITAL PROJECTSfalsefalsetrue

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindRefunding EscrowRefundingEscrow
43328002505043947942009falsefalsetruetrue
45585010622011truefalsetruetrue454788

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsefalse0.003800.00380true
falsefalsefalsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsetruefalsefalsefalsefalse
falsetruefalsefalsefalsefalse

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE KReturnReference
Explanation2006A MI STATE HOSPITAL FINANCE IT HAS BEEN DETERMINED THAT NO ARBITRAGE REBATE IS DUE FOR THIS BOND ISSUE THEREFORE FORM 8038T IS NOT REQUIRED MICHIGAN FINANCE AUTHORITY SER D THIS BOND ISSUE IS A TRANSACTION WITH NO INVESTMENT OF PROCEEDS THEREFORE NO ARBITRAGE REBATE CALCULATION IS REQUIREDExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE PREDOMINANT PROVIDER OF PRIMARY CARE IN THE COMMUNITIES WE SERVE.
ADDITIONAL INFORMATIONFORM 990ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. PART I, LINES 3 & 4 AND PART VI, SECTION A, LINE 1 - THOSE MEMBERS WHO ARE NOT INDEPENDENT ARE EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION LISTED IN SCHEDULE R AND ARE COMPENSATED AT MARKET VALUE FOR THE SERVICES PROVIDED TO THAT ORGANIZATION.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6THE SOLE MEMBER OF THE CORPORATION IS MIDMICHIGAN HEALTH.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BTHE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; AND G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 INFORMATION IS PREPARED BY THE FINANCE STAFF AT MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THIS ORGANIZATION. THE INFORMATION IS SUBMITTED FOR REVIEW BY A SENIOR FINANCE STAFF MEMBER AT MIDMICHIGAN HEALTH. THE STAFF MEMBER IN CONSULTATION WITH OUR TAX ACCOUNTANT (A CERTIFIED PUBLIC ACCOUNTING FIRM) REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. ONCE THE INITIAL REVIEW IS COMPLETE, THE INFORMATION IS SUBMITTED TO OUR TAX PROFESSIONALS AT ANDREWS HOOPER PAVLIK PLC. UPON REVIEW BY THEIR PROFESSIONALS,INCLUDING A SENIOR MANAGER, INFORMATION IS RETURNED TO MIDMICHIGAN HEALTH FOR ITS FINAL REVIEW. THIS REVIEW INCLUDES A REVIEW BY THE SVP AND TREASURER. ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MIDMICHIGAN HEALTH CEO PRIOR TO FILING. PRIOR TO FILING: THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION WILL BE REVIEWED BY THE COMPENSATION COMMITTEE. FORM 990, INCLUDING ALL SCHEDULES, WILL BE MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS IN A SECURE ELECTRONIC FORMAT WITH A SUMMARY OF ALL THE MAJOR CHANGES FROM THE PRIOR YEAR RETURN PRIOR TO FILING. QUESTIONS OR CONCERNS WILL BE ADDRESSED BY THE SVP AND TREASURER. THE RESULTS OF THESE REVIEWS WILL BE PRESENTED TO THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS AND THIS ORGANIZATION'S BOARD OF DIRECTORS.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE, AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; AND 3) TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MIDMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES ARE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND ABSTAIN FROM VOTING ON ANY ISSUE IN WHICH THEY ARE NOT IMPARTIAL.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15AALL CEOS AND OPERATING OFFICERS COMPENSATION IS ANNUALLY APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF MIDMICHIGAN HEALTH. THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BALL OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIINO DIRECTORS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD. THEY ARE CONSIDERED TO WORK AN AVERAGE OF 2 HOURS A WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK RELATED TO THEIR FULL-TIME POSITION. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MIDMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES IS NOT TRACKED BY AFFILIATE. THEREFORE THE FULL TIME SERVICE TO ALL AFFILIATES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5REALIZED GAINS (OTTI AND ALTERNATIVE INVESTMENTS) 109,242 UNREALIZED GAINS 2,226,517 ------------ 2,335,759

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
MIDMICHIGAN HEALTH
4000 WELLNESS DRIVEMIDLANDMI48670382459948SUPPORTMI501C311ANAfalse
MIDMICHIGAN MEDICAL CENTER-MIDLAND
4000 WELLNESS DRIVEMIDLANDMI48670380833014HOSPITALMI501C33MIDMI HLTHtrue
MIDMICHIGAN MEDICAL CENTER-GRATIOT
300 E WARWICK DRALMAMI48801381437919HOSPITALMI501C33MIDMI HLTHtrue
MIDMICHIGAN MEDICAL CENTER-GLADWIN
515 QUARTER STREETGLADWINMI48624386020434HOSPITALMI501C33MIDMI HLTHtrue
MIDMICHIGAN STRATFORD VILLAGE
2121 ROCKWELL DRMIDLANDMI48642382623324LT CAREMI501C39MIDMI HLTHtrue
MIDMICHIGAN GLADWIN PINES
449 QUARTER STREETGLADWINMI48624382754875LT CAREMI501C39MIDMI HLTHtrue
MIDMI VNA DBA MIDMICHIGAN HOME CARE
3007 N SAGINAW RDMIDLANDMI48640381459397HOME EQUIPMI501C39MIDMI HLTHtrue
MIDMICHIGAN PHYSICIANS GROUP
2620 W SUGNET ROADMIDLANDMI48640383317788MED OFFICEMI501C311AMIDMI HLTHtrue
MIDMICHIGAN REGIONAL IMAGING
2618 N SAGINAWMIDLANDMI48670352182295EQUIPMENTMI501C311BMIDMI HLTHtrue
MIDMICHIGAN URGENT CARE
3009 N SAGINAW RDMIDLANDMI48640205064848AMBULATORYMI501C39MIDMI HLTHtrue
MIDMICHIGAN HEALTH DEV ASSOC
4000 WELLNESS DRIVEMIDLANDMI48670382459947OPERATIONSMI501C2MIDMI HLTHtrue
REGIONAL DIALYSIS SERVICES
PO BOX 608ALMAMI48801383120704DIALYSISMI501C311AMIDMI HLTHtrue
MIDMI MED CENTER-CLARE VOLUNTEERS
703 NORTH MCEWAN STREETCLAREMI48617382944967SUPPORTMI501C311ANAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN ASSURANCE GROUP LTDBusinessNameLine1

Address Foreign AddressForeign

FieldValueIRS element (for citing)
Address Line1PO BOX 1051 23 LIME TREE BAY AVENUEAddressLine1
Address Line2GOVERNORS SQUARE BLDG 4 2ND FLOORAddressLine2
Province Or StateGRAND CAYMANProvinceOrState
CountryCJCountry
FieldValueIRS element (for citing)
EIN980585596EIN
Primary ActivityINSURANCEPrimaryActivity
Legal Domicile Foreign CountryCJLegalDomicileForeignCountry

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MIDMI HLTHBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (16 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MIDMICHIGAN REGIONAL IMAGING
J781258BOOKS RECORDS
MIDMICHIGAN HEALTH DEV ASSOC
J117547BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-MIDLAND
O2523472BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-GRATIOT
O190375BOOKS RECORDS
MIDMICHIGAN HEALTH
O645804BOOKS RECORDS
MIDMICHIGAN PHYSICIANS GROUP
O6264851BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-MIDLAND
P209653BOOKS RECORDS
MIDMICHIGAN PHYSICIANS GROUP
P103956BOOKS RECORDS
MIDMICHIGAN REGIONAL IMAGING
J781258BOOKS RECORDS
MIDMICHIGAN HEALTH DEV ASSOC
J117547BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-MIDLAND
O2523472BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-GRATIOT
O190375BOOKS RECORDS
MIDMICHIGAN HEALTH
O645804BOOKS RECORDS
MIDMICHIGAN PHYSICIANS GROUP
O6264851BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-MIDLAND
P209653BOOKS RECORDS
MIDMICHIGAN PHYSICIANS GROUP
P103956BOOKS RECORDS

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